pictorial COMMENTARY
CEREBRAL MALARIA
Contributed by: KP. Aravindan, MD,
Government Medical College, Alappuzha, India
Autopsied brain of a guest worker from Orissa seen through the microscope. The delicate branching capillaries are full of tiny dark dots, which are Plasmodium falciparum parasites within red cells.
Cerebral malaria remains a huge killer accounting for thousands of deaths mainly in the eastern part of India. It can only be countered when we have a clear understanding of the molecular mechanisms involved in the disease.
The parasitized red cells express on their surface parasite proteins, especially a sticky adhesion protein called PfEMP1. This binds to receptors on the endothelial cells of capillaries, important among them being a molecule called CD36. The parasitized red cells also stick to non parasitized ones forming aggregates. All this results in clogging of these vessels with deadly effects.
No wonder a lot of scientists now concentrate on these molecules. Below are links to two recent articles.
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- Janes JH, Wang CP, Levin-Edens E, Vigan-Womas I, Guillotte M, Melcher M, Mercereau-Puijalon O, Smith JD. Investigating the host binding signature on the Plasmodium falciparum PfEMP1 protein family. PLoS Pathog. 2011;7:e1002032.
- Rao A, Kumar MK, Joseph T, Bulusu G. Cerebral malaria: insights from host-parasite protein-protein interactions. Malar J. 2010;9:155.
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Autopsied brain of a guest worker from Orissa seen through the microscope. The delicate branching capillaries